Heart boosting drug could save thousands

Thousands of lives could be saved each year by a new technique that stimulates the hearts of patients recovering from major surgery, it has been claimed.

The system involves careful monitoring of blood flow around the body and the use of a drug to boost the rate and force of heart beats.

By ensuring just the right amount of oxygen is carried by the blood to vital organs, the risk of potentially fatal post-operative complications is greatly reduced.

Doctors believe if the technique, called Goal Directed Therapy, (GDT) was introduced for the most at-risk patients, up to 3,000 lives could be saved in NHS hospitals each year.

Drug could reduce hospital stays

Cutting the amount of time patients spent in hospital could also save the health service hundreds of millions of pounds.

Findings from a GDT trial involving patients at St George's Hospital, London, were published in the journal Critical Care.

A total of 122 patients were recruited, of whom 62 received Goal Directed Therapy while recovering from surgery.

All were high risk patients who had to be transferred to an intensive care unit after their operations.

The treatment uses a special monitoring device attached to the patient which keeps a careful watch of blood flow and the amount of oxygen being delivered to the body's organs.

If oxygen levels dip too low, a heart-boosting drug is administered via an intravenous drip. The drug, dopexamine, causes the heart to beat faster, with stronger contractions, while the blood vessels widen.

The aim is to achieve the "goal" of delivering 600 millilitres of oxygen to the organs per minute.

Complications fell by 40 per cent

Over a period of 60 days, 44 per cent of GDT patients suffered complications compared with 68 per cent of those not offered the treatment, a reduction of almost 40 per cent.

The average length of stay in hospital for patients receiving Goal Directed Therapy fell by 12 days from 29.5 for the control group to 17.5.

Although death rates were not the prime focus of the study, extrapolation of the results suggests that the technique could save many lives.

Study leader Professor David Bennett, an intensive care specialist at St George's, said: "About 8,000 patients who end up in intensive care after surgery will die.

"We estimate that if this sort of protocol was implemented nationwide, just for intensive care patients, at a conservative estimate you would be saving two to three thousand lives a year."

Stimulating the heart can be stressful, so care has to be taken when using the technique. But there was no evidence of it causing any damage to heart muscle, said Prof Bennett.

He said GDP patients were much less likely to suffer post-operative wound infections - a finding with implications for the control of hospital "superbugs" such as MRSA.

Twenty patients in the control group - about a third of the total - compared with just four in the treated group, picked up wound infections.

NHS could save £100million

Reducing the length of time high risk surgery patients spend in hospital could save the NHS at least £100million a year, the findings suggest.

But Prof Bennett said the savings could potentially be much greater. Extending the same approach to less at risk patients could slash up to £1billion off the NHS hospital bill.

Dr Anna Batchelor, president of the Intensive Care Society, said: "The St George's experience is excellent news for thousands of patients who undergo major surgery in this country every year.

"By optimising the heart function of patients who are at high risk around the time of their operation, we can reduce the risk of them developing infections or complications so that more patients survive and leave hospital earlier."

Each year, more than three million surgical operations are carried out in the UK. In total, some 25,000 patients die each year after surgery - a mortality rate of about 0.8 per cent.

Death rates for the 40,000 NHS patients admitted to intensive care after major surgery are much higher, at around 20 per cent.